Microembolization is commonly associated with carotid artery stenting (CAS), but our understanding of subclinical microembolization is superficial. Through collaborative effects of multidisciplinary team-experts, novel approaches, and longitudinal evaluations, we hope to better understand the clinical significance and long-term cognitive effects of microemboli. This proposal may change our current clinical practice by providing a better outcome measure for carotid interventions and improving outcomes of CAS procedures through risk factor stratification. Our central hypothesis is that development of subclinical microemboli is associated with decline in cognitive function following CAS and that the risk of development of microemboli themselves is associated with patient- and procedure-related factors. We hope that this prospective study will help to clarify these important issues in the era of rapidly evolving percutaneous interventions.

Carotid revascularization can significantly reduce the risk of stroke in patients with severe carotid stenosis; however, it has been associated with cognitive decline in 25% of the older adults who undergo the procedure. Neuroimaging techniques that characterize white matter integrity and regional hypoperfusion have the potential to provide sensitive brain structure indicators that may be associated with memory decline following revascularization procedures. In this proposal, we hope to determine the risk factors and cognitive effect of microembolization following carotid revascularization procedures.

Behavioral: Neuropsychological testing

Eligibility

Ages Eligible for Study:

40 Years and older (Adult, Senior)

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

Yes

Sampling Method:

Non-Probability Sample

Study Population

Patients undergoing carotid intervention

Criteria

Inclusion Criteria:

Patient is male or female >40 yrs of age.

Patient has occlusive extracranial carotid stenosis (≥70%)

Patient is scheduled to undergo an endovascular intervention of a lesion in the extracranial carotid artery

Patient agrees to voluntarily participate and signs an informed consent.

Patient agrees to be available for follow-up and is able to participate in all study testing procedures.

Patient has sufficient visual and auditory acuity for cognitive testing.

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01718600